Commentary: Health Inequity Is Health Injustice

Leadership

By: Paula Schneider, President and CEO of Susan G. Komen

04-09-2018

The following appeared in U.S. News and World Report on April 6, 2018.

On the surface, there are reasons to be optimistic about the progress we've made fighting breast cancer. Over the 35 years that the Susan G. Komen breast cancer organization has been in existence, overall death rates have declined meaningfully. New treatments and approaches are extending lives.

But this progress has been inconsistent. Death rates for black women in the U.S. – African-Americans, Africans or those descended from Africans in the Caribbean and elsewhere – are more than 40 percent higher than those of white women. In some cities, like Memphis, Tennessee, that number is as high as 70 percent.

Some die because treatments fail. Some, because African-American women are often diagnosed at later stages of breast cancer, when it is more difficult to treat. Many die because the benefits of our health care system are not distributed equally to them.

This is health inequity, and this is what we're fighting to end. Health inequity is health injustice. It strikes many women, but seems to disproportionately strike black women.

It's a fatal injustice that should make us all mad.

I took the reins of Susan G. Komen in November 2017, coming from private companies where bottom lines and returns on investment are the reasons for existing. I can think of no greater return on investment than lives saved. I came to Komen as a breast cancer survivor whose mother died of metastatic breast cancer eight years ago. I have two daughters whom I love very much. I never want them to hear the words, "You have breast cancer."

I'm not the only person who feels this way: There are 3.5 million breast cancer survivors in the U.S., both men and women. Many are mothers, grandmothers, aunts, dads, uncles, grandfathers, brothers or sisters. Whatever their roles in the lives of their families, none would ever wish their experience on the generations to follow.

Paula Schneider, President and CEO of Susan G. Komen

"Health inequity is health injustice. It strikes many women, but seems to disproportionately strike black women. It's a fatal injustice that should make us all mad."

At Komen, one of our core priorities is to dramatically boost our focus on health equity, and to reduce breast cancer deaths in the U.S. by 50 percent by 2026. We have fought to improve health equity for years as the only breast cancer organization that works in laboratories, in neighborhoods, with lawmakers and globally to tend to the needs of people facing this disease. We know that women of all colors, religions and ethnicities die because they don't have adequate health insurance, money or social support.

Too many fear that they'll lose their jobs if they take time off for treatment. Some are cutting their medication in half to stretch their dollars, which can lead to poor outcomes such as recurrence or even death. Some are deciding whether to feed their kids or use that money for bus fare to treatment. Some are homeless, struggling or working, but just not making enough to cover the costs – for some, a month's worth of out-of-pocket expenses can far exceed a month's pay.

Even the insured and the more affluent find the economic burden of cancer treatment a nightmare – selling their homes, cashing in retirement savings, draining bank accounts and filing bankruptcy to cover the medical costs.

Helping to get women and men screened, paying co-pays, helping with living expenses, arranging for transportation – we've done all this for decades because we know these efforts lower the odds that a person will die of this disease.

We will continue to serve all people, with a focus on the African-American community to fight a pandemic. We are putting into action an African-American Health Equity Initiative aimed specifically at black women. Armed with funding from the Fund II Foundation, this initiative is not a "we know best" effort, but a comprehensive series of initiatives designed with community experts, in 10 metropolitan areas and at the national level.

We've met extensively with civic, community, government, business and health care leaders in the 10 metropolitan areas – Memphis; Atlanta; Los Angeles/Long Beach; the District of Columbia; Houston; Dallas/Fort Worth; Chicago; St. Louis; Philadelphia; and Virginia Beach, Virginia – exploring the unique local issues that black women face. These local leaders have designed or are designing the programs to overcome local barriers to care, with issues ranging from a need for transportation to a deeper examination and coordinated effort to improve the quality of health care in a specific area.

Komen is there to support their efforts, with expertise gleaned from 35 years of breast cancer advocacy, and to help with resources that can move needles – and mountains.

We do this because all of us at Komen want to be sure that every woman or man receives the benefits of the best that our health care system has to offer, regardless of color, ZIP code, income or insurance status.

We can end deaths from breast cancer, and with the power of women and men behind us, we most definitely will.